Sanders Gillian D, Taira Al V
Center for Primary Care and Outcomes Research, 117 Encina Commons, Stanford University, Stanford, CA 94305-6019, USA.
Emerg Infect Dis. 2003 Jan;9(1):37-48. doi: 10.3201/eid0901.020168.
Human papillomavirus (HPV) infection, usually a sexually transmitted disease, is a risk factor for cervical cancer. Given the substantial disease and death associated with HPV and cervical cancer, development of a prophylactic HPV vaccine is a public health priority. We evaluated the cost-effectiveness of vaccinating adolescent girls for high-risk HPV infections relative to current practice. A vaccine with a 75% probability of immunity against high-risk HPV infection resulted in a life-expectancy gain of 2.8 days or 4.0 quality-adjusted life days at a cost of $246 relative to current practice (incremental cost effectiveness of $22,755/quality-adjusted life year [QALY]). If all 12-year-old girls currently living in the United States were vaccinated, >1,300 deaths from cervical cancer would be averted during their lifetimes. Vaccination of girls against high-risk HPV is relatively cost effective even when vaccine efficacy is low. If the vaccine efficacy rate is 35%, the cost effectiveness increases to $52,398/QALY. Although gains in life expectancy may be modest at the individual level, population benefits are substantial.
人乳头瘤病毒（HPV）感染通常是一种性传播疾病，是宫颈癌的一个风险因素。鉴于与HPV和宫颈癌相关的大量疾病和死亡情况，研发预防性HPV疫苗是公共卫生的一个优先事项。我们评估了与当前做法相比，为青春期女孩接种疫苗预防高危HPV感染的成本效益。一种对高危HPV感染免疫概率为75%的疫苗，相对于当前做法，可使预期寿命延长2.8天或质量调整生命天数增加4.0天，成本为246美元（增量成本效益为22,755美元/质量调整生命年[QALY]）。如果目前居住在美国的所有12岁女孩都接种疫苗，她们一生中可避免1300多例宫颈癌死亡。即使疫苗效力较低，为女孩接种高危HPV疫苗的成本效益也相对较高。如果疫苗效力率为35%，成本效益将增至52,398美元/QALY。尽管在个体层面预期寿命的增加可能不大，但对人群的益处是巨大的。
